NPIMap

Organization Active NPI

Mid-Delta Health Systems, Inc.

Doing business as Mid-Delta Health Systems - DeWitt

  • Federally Qualified Health Center (FQHC)
  • De Witt, AR
National Provider Identifier
1053938118
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MID-DELTA HEALTH SYSTEMS, INC.
Doing business as
Mid-Delta Health Systems - DeWitt
Practice address
1940 S Whitehead Dr
De Witt, AR 72042-2906
Phone
(870) 946-4505
Fax
(870) 946-3357
NPI assigned
Jul 6, 2020
Last updated
Mar 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MID-DELTA HEALTH SYSTEMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Monica Lindley
Title
Ceo
Phone
(870) 747-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1940 S Whitehead Dr
De Witt, AR 72042-2906

Mailing address

245 Madison St
Clarendon, AR 72029-2706
Phone (870) 747-1400

Other names 1

  • Mid-Delta Health Systems - DeWitt Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200807000766 AR Part A Provider - Federally Qualified Health Center (FQHC) 3870574668 Practice locations: Dewitt, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053938118. Details of each certification follow.

Federally qualified health center certification: CCN 041969

Legal name
MID-DELTA HEALTH SYSTEMS INC
Doing business as
MID-DELTA HEALTH SYSTEMS - DEWITT
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 6, 2020
Last certification
Aug 6, 2020
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
in AR
Enrollment address
1940 S Whitehead Dr
Dewitt, AR 72042-9512

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D0677682Mid-Delta Health Systems - Dewitt1940 S Whitehead Dr, De Witt, AR 72042Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Mid Delta Health System5 organizations share this tax ID, including this one
Part of
Mid Delta Health System

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Katherine Bennett Individual Corporate OfficerCoo Oct 1, 2019
W-2 Managing EmployeeChief Executive Officer (Coo) Sep 1, 2004
Duwinda Garrett Individual W-2 Managing EmployeeBiller/Coder/It Aug 1, 2012
Ruby Ellis Individual Corporate DirectorBoard Member Jun 1, 2018
Elizabeth Davenport Individual Corporate DirectorBoard Member Jun 1, 2011
Rebecca Broadnax Individual W-2 Managing EmployeeAr/Billing Mang Oct 1, 2014
Alice Smith Individual Corporate DirectorBoard Member Jan 1, 2013
Raymond Abramson Individual Corporate DirectorBoard Member Jun 1, 1997
Mid-Delta Health Systems Inc Organization, Clarendon, AR Non-profit 5% Or Greater Direct Ownership Interest Jun 26, 2020 100%
Operational/Managerial Control Jun 26, 2020 100%
Venita Black Individual Corporate DirectorBoard Member Jun 1, 2018
Rick Glover Individual Corporate DirectorBoard Member Jun 1, 1999
Carlee Latham Individual Corporate DirectorBoard Member May 1, 2013
Monica Lindley Individual Corporate DirectorExecutive Director Jun 26, 2020 100%
W-2 Managing EmployeeExecutive Director Oct 1, 2019
Karen James Individual Corporate DirectorBoard Member Jul 21, 2011
Marco Middleton Individual Corporate DirectorBoard Member Jun 1, 2019

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mid-Delta Health Systems-StuttgartStuttgart, AR, CCN 041024 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Sep 16, 2022
Sep 16, 2022
Lion's ClinicClarendon, AR, CCN 041044 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Oct 2, 2023
Oct 2, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Mid-Delta Health Systems, Inc.

    dba Mid-Delta Health Systems - Stuttgart

    • Federally Qualified Health Center (FQHC)
    • Stuttgart, AR
    • NPI 1205551884

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Mid-Delta Health Systems, Inc.

    dba Lion Clinic

    • Federally Qualified Health Center (FQHC)
    • Clarendon, AR
    • NPI 1679354468

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1053938118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 MADISON ST",
            "city": "CLARENDON",
            "state": "AR",
            "postal_code": "720292706",
            "telephone_number": "870-747-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 S WHITEHEAD DR",
            "city": "DE WITT",
            "state": "AR",
            "postal_code": "720422906",
            "telephone_number": "870-946-4505",
            "fax_number": "870-946-3357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-DELTA HEALTH SYSTEMS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MID-DELTA HEALTH SYSTEMS, INC.",
        "enumeration_date": "2020-07-06",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "LINDLEY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "870-747-1400"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-Delta Health Systems - DeWitt",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in De Witt, AR

Sources for this page

Verify at the official NPI Registry.